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Individual

CHERYL BLAUTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
360 HUNTINGTON AVE, NORTHEASTERN DEPARTMENT OF ATHLETICS 219 CABOT CENTER, BOSTON, MA 02115-5005
(617) 373-4068
Mailing address
NORTHEASTERN UNIVERSITY 219 CABOT CENTER, DEPARTMENT OF ATHLETICS, BOSTON, MA 02115-5000

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
01752
MA

Other

Enumeration date
03/22/2007
Last updated
07/08/2007
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